PurposeA total of 478,000 children in England are reported to live with a parent who uses substances. The presence of a stable non-substance using caregiver within the family has been found to be one protective factor for children (Velleman and Templeton, 2016), yet there is a lack of research examining how to intervene with non-substance using parents/caregivers. This study aims to co-produce an intervention for non-substance using parents/caregivers and their children.Design/methodology/approachThis study had three phases: interviews with practitioners, exploring their perceptions of whom non-substance using parents/caregivers seek support from, the type of support needs they had and what influenced their decision-making; interviews with parents/caregivers to examine their support needs and experiences of help seeking; and co-production workshops with parents/caregivers and practitioners to discuss the findings and design of an intervention.FindingsParents/caregivers reported experiencing challenges in talking to their child(ren) about the other parent/caregiver's substance use. They highlighted the importance of a structured intervention to support them to initiate conversations with children about how parental substance use impacted the child and wider family in a way that parents/caregivers felt was age-appropriate and sensitive and supported them in their caregiving role to children.Research limitations/implicationsA limitation of this study relates to the participation of parents/caregivers who were not in receipt of support services. Recruitment was predominantly via specialist carer support organisations, and although this often presented an opportunity to talk with parents/caregivers who were open to the idea of discussing parental substance use, the authors are mindful of the differing view that parents who were not in receipt of support may have expressed about the potential of an intervention.Practical implicationsThis study highlights the often-overlooked impact of parental substance use on parents/caregivers who do not use substances and often manage dual roles as caregiver to a child and their partner/ex-partner or family member who uses substances. In particular, it seeks to emphasise the impact on parents/caregivers parenting and acknowledge the challenge of managing their own emotions whilst maintaining stability for the child.Social implicationsThis research suggests characteristics of an intervention that could be used to support family relationships when talking to children about the impact of parental substance use. It attempts to create space for families to convey that it is ok for children to talk about how this impacts upon their lives.Originality/valueThere is a lack of research examining how to intervene with non-substance using parents or other caregivers to support them in their parent/caregiver role. This study suggests ways for parents/caregivers to provide emotional support to their child(ren) impacted by parental substance use.

Abstract Background Parental Intimate Partner Violence and Abuse (IPVA) is a complex issue, which requires a sensitive response from a range of services. This review aimed to identify and synthesise qualitative research examining the perceptions and experiences of parents and children affected by IPVA and their interactions or engagement with various child welfare, health and legal systems and services. Methods We conducted a systematic review of the international literature, searching 11 electronic databases from inception to November 2023 and supplemented this with a grey literature search. Studies were included if they provided qualitative accounts from adult and/or child victims/survivors of IPVA and/or adult perpetrators reporting on experiences of child welfare, health, and/or criminal justice intervention. Results A thematic synthesis of 39 individual studies (38 papers and 1 book chapter) which include the perspectives of (n-825) mothers/adult females (n-107) children and (n-58) fathers was undertaken. Three overarching themes were identified: (1) the importance of supporting the family whilst safeguarding the child (2) systems failing of services to hold the perpetrator to account and (3) systems that retraumatize the Family. Conclusions Services should provide a whole-family approach, which responds to the needs both the parent and child victim/survivor, and recognises the parental identity of the perpetrator. Interventions with adult victims/survivors should take a strengths-based approach, whilst holding the perpetrator to account. Particular care is needed when families are involved in family court to avoid re-traumatisation.

To examine the perspectives and experiences of multi–agency practitioners involved in supporting families affected by domestic abuse (DA) to inform changes that are required to better meet the needs of affected families. This article focuses on (a) how DA is differentially understood and interpreted, (b) the possible reasons identified for differential understanding and interpretation and (c) its perceived impact on risk assessment and service delivery. A case study approach within a North East Local authority located in the United Kingdom (UK), was adopted. Thirty-one 1:1 online qualitative interviews were conducted with multidisciplinary professionals between June – December 2022. The findings are based upon a combination of deductive-inductive thematic analysis. There was an absence of a shared understanding of DA among practitioners involved in multi-agency working despite a national-level definition available in the UK. This was identified as one of the key barriers to multiagency working subsequently affecting consistent response to families affected by DA. Data from this case study emphasizes the importance of developing a uniform understanding of DA among practitioners to adequately respond to the distinctive needs of families who are affected by it. The findings from the article can also inform broader debates in the DA literature related to complexities surrounding definitions and associated interpretations. Practice and policy implications are also discussed.

There is considerable investment by government policymakers in supporting pilot innovation in public services, following which pilots prove difficult to sustain. Our 4-year longitudinal study of three pilot innovations in England, which seek to support the transition of care leavers into adulthood, provides insight into how such pilots can be sustained. Conceiving innovation as a journey, our study first identifies the dynamics of innovation around five key ingredients: the role of senior managers in cultivating a receptive context for innovation, distributed leadership, user co-production, measurement of outcomes, and innovation adaption. Second, our study highlights some ingredients are more important as implementation of innovation is initiated and may fade in importance as the innovation journey proceeds. Third, our study shows innovation ingredients are shaped by organizational contingencies of performance and financial pressures. Finally, we suggest a need for a contextualized implementation science framework to examine innovation in social care.

Children in care of the state are amongst the most disadvantaged in society. They have often experienced adverse childhood experiences leading to their care entry including abuse and neglect. Longitudinal data suggests problems children in care of the state experience within adolescence persist into adulthood, showing “a continuing legacy of adversity.” Emerging literature shows that edge of care interventions can bring about benefits. These interventions support families to meet their child’s needs and prevent, or reduce, the likelihood of children going into care. However, it is not clear how or why these interventions work. It is important to develop this understanding to inform the development of effective, theory-informed practice to benefit this population. We reviewed and synthesised published literature to expose mechanisms by which interventions may promote and support family preservation for children at the edge of care. Our synthesis uses a realist approach to examine mechanisms by which interventions, in various contexts, can promote and support family preservation for children at the edge of care. Previous work by the team shaped the initial search strategy and in line with RAMESES realist review guidelines, no restrictions were placed on the types of study to be included in the synthesis. From 7,530 potentially relevant references identified, 61 papers were included in final extraction. Extracted data was themed, prior to developing narrative and formulating programme theories. Effective edge of care service operation seemed to be based on four core programme theories pertaining to the need for family skills training, home-based delivery, dedicated worker, and rapid response to need.

There is a growing trend towards the use of participatory methods, within health and social care research and an increase in the inclusion of Peer Researchers in leaving care studies internationally. Whilst multiple benefits have been identified, they are not automatic and consideration also needs to be given to the complexities involved and how challenges might be mitigated. This paper focuses on the participation of care-experienced young people as Peer Researchers in an inter-disciplinary study examining how to sustain, scale and spread innovation to support young people's transitions from care. It shares learning from a nested action research study that was co-developed to explore and support Peer Researchers' contribution to and participation in the wider study. Key learning from the qualitative survey and focus groups centred on the discovery and application of the Ability-Motivation-Opportunity ('A-M-O') theoretical framework [Applebaum, E., Bailey, T., Berg, P., & Kalleberg, A. L. (2000). Manufacturing advantage: why high performance work systems pay off. ILR Press.] and its use to explore, analyse, reflect on and develop the Peer Researcher role. The application of A-M-O as an analytical and reflective tool offers a valuable and practical way to develop Peer Researchers' contribution to and participation in and beyond health and social care research studies. Dieser Artikel beginnt mit einer kurzen Darstellung der gegenw & auml;rtigen sozial-& ouml;kologischen Krise und ihrer zentralen Auswirkungen auf die Lebensbedingungen von Kindern und Jugendlichen. Er reflektiert dann diese herausfordernde strukturelle und entwicklungsbezogene Situation innerhalb der Perspektiven der Sozialen Arbeit, der Sozialp & auml;dagogik, der Kinder- und Jugendhilfe und der neueren Konzepte der sozial-& ouml;kologischen Sozialen Arbeit. Danach werden sozialr & auml;umliche Ans & auml;tze der Sozialen Arbeit vorgestellt und in Bezug auf ihre Potenziale und Begrenzungen der Adressierung sozial-& ouml;kologischer Probleme reflektiert. Das letzte Kapitel stellt dann erste Ausblicke bereit, wie sozial-& ouml;kologische und sozialr & auml;umliche Ans & auml;tze in der Kinder- und Jugendhilfe implementiert werden k & ouml;nnten, um die gegenw & auml;rtigen Herausforderungen und Bedarfe zu adressieren.

This chapter intends to provoke thought around assumptions about young people providing care, what influences how young carers are perceived and how stigma and judgement associated with caring are discussed. We conclude by emphasising the significance of the role as an educator in creating discussion about the breadth and diversity of care experiences. This role includes both educating young people about young caring and being mindful that your students may currently be or previously been a young carer.

Background:Parental substance use is a substantial public health and safeguarding concern. Research examining the impact of parental substance use upon children is well-established, but there is a lack of research examining how parents/caregivers cope with their parenting role within the context of another parent's substance use, or how best to support these parents/caregivers. Objective:This paper examines the experiences and support needs of parents/caregivers impacted by another parent's substance use. Participants:Nineteen parents/caregivers from substance exposed families via local community-based voluntary sector support organizations, in urban and rural settings in northeast England. Methods:Qualitative, in-depth interviews with caregivers (mothers, fathers, grandparents, aunts, uncles, siblings, aged 25 to 65+ years) of dependent aged children (aged 4 to17 years) in substance exposed families. Thematic analysis explored their experiences and support needs. Results:Cumulative stress impacted parents/caregivers in their parenting role, creating further challenges in caring for children impacted by another parent's substance use. Parents/caregivers felt their needs went unrecognized by support services, and interactions with statutory services frequently exacerbated their stress. Parents/caregivers worried about what to disclose to children about substance use and how and when to do this. Conclusion:Parents/caregivers attempted to mitigate the risk of another parent's substance use upon the children in their care. They often perceived lack of appropriate support specifically for parents/caregivers, particularly considering the extra challenges they faced caring for children in the context of parental substance use. Resources to support parents/caregivers in talking with children about these issues may offer guidance and reassurance to caregivers to alleviate some of their stress.

We examine the outcome measurement landscape in care leaver innovation, where many innovations to support transitions of young people leaving care fail to sustain beyond a fixed-term pilot, and fewer impact wider transition policies. Our empirical qualitative study comprises interviews with 31 senior UK children's social care policy and practice professionals, 103 interviews across five innovation-focused case studies within England with a range of public and private providers. We consider these data in relation to evaluations from a nationally diffused social care innovation. We identified three measurement landscape challenges. First, we highlight the limits of the economically oriented measurement and identify an overlooked outcome measurement demand. Second, we emphasise a need to stratify care leaver population outcomes to better reflect individuals transition through different domains of life and trajectory. Third, we identify areas of precarity around the intended use of care leaver experience. We conclude that tensions exist between the pull towards a unified approach to outcome measurement and the reality of decoupled outcome requirements and legitimacy-seeking priorities which differ according to stakeholder. These tensions entrench stagnant innovation. Recognition of roles and legitimacies that exist across the process of care leaver innovation is warranted. Opportunities for action are discussed. This empirical research article details three challenges reflected in the current outcome measurement landscape in relation to care leaver innovation. We use qualitative, case study research methods including interviews and observation to collect and analyse data. We consider policy, practice and care leaver experiences as stakeholders in this process, and the effects that outcome measurement has on each of these groups. We identify tensions between the legitimate, necessary needs of each group participating within the care leaver innovation process. We discuss opportunities for improving the understanding and interaction between each of these important parts of the care leaver innovation process.

Many parents who come into contact with early help and children's social care services are risky drinkers. This study aimed to investigate the feasibility and acceptability of conducting a trial of brief alcohol interventions within this setting. We conducted a three-arm pilot feasibility cluster randomised controlled trial in the North-East of England. The additive interventions were: i) screening and a healthy lifestyle leaflet (control); ii) brief advice; iii) extended brief intervention. The trial was later reduced to two-arm due to the extended brief intervention being infeasible. Of the 1769 parents that were approached, 429 consented to be screened (24%), the majority were eligible to participate (n = 415; 97%), 147 of which (35%) scored ≥5 on the AUDIT-C screening tool. There were 108 parents (74%) who consented to participate in the trial (n = 50 control; n = 58 brief advice). Follow-up rates at 6 and 12-months were 61% and 43%. The TLFB30 was found to be a suitable tool to measure the primary outcome of heavy episodic drinking. Qualitative data showed that parents and practitioners largely found trial procedures to be acceptable, however, care should be taken when discussing alcohol risk with parents in this setting. Most of the a-priori success criteria were met in this pilot feasibility trial. The findings suggest that it may be feasible to conduct a two-arm randomised controlled trial of brief alcohol interventions to parents in contact with early help and social care. The TLFB30 was found to be a suitable tool to measure the primary outcome of heavy episodic drinking.

AIMS:There is substantial evidence showing an association between parental substance use and child substance use and/or mental health problems. Most research focuses upon maternal substance use, with the influence of paternal substance use often being overlooked. We aimed to investigate the differential effects of maternal and paternal substance use upon children aged 0-18 years. METHODS:We used systematic review methods to identify observational studies examining the association between either maternal or paternal substance use and child substance use and/or mental health problems. The odds ratio (OR) effect measure was used, for ease of computation. We used a random-effects model with the inverse variance method to meta-analyse the findings from eligible studies. RESULTS:We included 17 unique studies with a total of 47 374 child participants. Maternal and paternal substance use were both associated with increased odds of child any drug use [OR = 2.09; 95% confidence interval (CI) = 1.53, 2.86; n = 12 349 participants; three studies and OR = 2.86; 95% CI = 1.25, 6.54; n = 5692 participants; three studies, respectively], child alcohol problem use (OR = 2.16; 95% CI = 1.73, 2.71; n = 7339 participants; four studies and OR = 1.70; 95% CI = 1.36, 2.12; n = 14 219 participants; six studies), child externalizing problems (OR = 1.81; 95% CI = 1.01, 3.22; n = 1748 participants; three studies and OR = 1.60; 95% CI = 1.18, 2.17; n = 2508 participants; six studies) and child internalizing problems (OR = 1.60; 95% CI = 1.25, 2.06; n = 1748 participants; three studies and OR = 1.42; 95% CI = 1.12, 1.81; n = 2248 participants; five studies). Child any alcohol use was associated with maternal substance use only (OR = 2.26; 95% CI = 1.08, 4.70; n = 28 691 participants; five studies). CONCLUSIONS:Both maternal and paternal substance use are associated with child substance use and mental health problems.

Global research has shown that most young people who are care experienced are not prepared to transition to independent living at 18 years of age and require support into early adulthood. We used rigorous systematic methods to identify English-based peer reviewed and grey literature describing innovations relevant to care experienced young people as they transition into adulthood, with a focus upon lessons for their implementation and diffusion. We synthesised the evidence narratively and organise data linked to seven key areas important to the transition to adulthood: (1) Health and well-being; (2) relationships; (3) education and training; (4) employment; (5) participation in society; (6) accommodation; (7) other. Twenty-five papers met our inclusion criteria. This review has found that, whilst there are a broad spectrum of innovations taking place within the social care environment for care experienced young people to support their transition into adulthood, there exists limited insight into how best to support implementation and diffusion of evidence-based innovation. We drew upon the 'Consolidated Framework for Implementation Research', developed in the setting of clinical service delivery, to highlight challenges in implementing and diffusing evidence-based innovation for care experienced young people transitioning into adulthood.

Meeting the multiple and often complex needs of families (children, young people and adults) within 'Early Help' support is dependent upon practitioners from different sectors sharing relevant and timely information, after gaining a family's voluntary consent to share information. This article reports on qualitative one-to-one interviews with adults in families (n = 32), one mother/father dyad interview (n = 2) and focus groups with practitioners (n = 47) in five local authority areas in North East England receiving or providing Early Help support. We explored experiences of providing consent to share personal information and consider the usefulness of a digital health data system when providing Early Help support to families. Communication Privacy Management theory was used as a framework to analyse the data. Key themes in participants' accounts include the degree of need for help and support; the importance of trusting relationships; stronger and structured joint working practices; and understanding how information is shared. This work provides insights into current information sharing practices for some of the most vulnerable families and the wider social contexts. It has implications for the usefulness of a digital data system that shares GP health data with Early Help services and suggests the role this could have in the parent-practitioner relationship. Early Help support can be provided to children and their families as soon as a problem emerges, to help them overcome the challenges they face. This support is voluntary and for practitioners to share information about a family's circumstances with another organisation, parents are required to give their permission for this to happen. There are several factors that can influence if and how information sharing happens. These factors should be considered when designing new ways of sharing information such as digital data sharing systems.

Abstract Aims Many parents in contact with children’s social care services misuse alcohol however do not meet the threshold for specialist alcohol treatment, and typically do not receive appropriate support for their needs. Brief alcohol interventions have been found to be effective in healthcare settings, however, it is unknown whether the brief intervention structure delivered within health settings would transfer well into children’s social care. This paper aims to examine the characteristics of brief intervention for alcohol misusing parents which social care practitioners consider to be important and acceptable to implement in this sector. Methods We assessed preferences for, and acceptability of, brief alcohol intervention with parents in contact with children’s social care using a discrete choice experiment. We recruited 205 children’s social care practitioners from London and the North East of England. Data were analysed using mixed logit which accounted for repeated responses. Findings Six attributes showed statistically significant coefficients, suggesting that a brief intervention with these attributes would encourage implementation. These were: level of alcohol-related risk targeted; intervention recipient; timing of intervention; duration of sessions; number of sessions and intervention structure. The attribute of most importance identified based on the attribute with the largest coefficient in the conditional logit model was risk level. Conclusions Brief alcohol interventions delivered to parents in social care should focus on the impact upon children and the wider family, they should be a flexible part of on-going casework and should be more intensive and less structured.

Parental substance use is highly prevalent worldwide, presenting major child safeguarding and public health concerns. Qualitative research enables in-depth understanding of how young people experience parental substance use and helps inform practice and policy through illustrative cases of experiences. This review aimed to synthesize published qualitative evidence exploring the lived experiences, perceived impact, and coping strategies of children and young people whose parents use substances. International literature databases including Medline, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, International Bibliography of the Social Sciences, Social Science Database, Sociology Collection, and Scopus were searched from inception to 2022, alongside grey literature searching and relevant websites. Qualitative accounts were included, provided by participants aged below 25 years. No language, date, or geographical limits were applied. A thematic synthesis of 35 studies, across 49 papers, covering over 700 children and young people’s voices, identified five overarching themes. These themes included, (a) living with the unpredictable: insecurity within the family; (b) social and emotional impact of parental substance use; (c) controlling the uncontrollable: creating safety within the family; (d) coping with and resisting the emotional and social impacts; and (e) formal and informal support. The findings emphasize that children and young people who experience parental substance use are trying to manage and mitigate vulnerabilities and be resilient to unpredictable, adverse, and often stigmatizing experiences, usually without formal support in place. Further research is needed to coproduce child-centered interventions that promote children and young people’s social and emotional resilience.

Objectives: The COVID-19 pandemic has exacerbated intimate partner violence and abuse. Incidents of intimate partner violence and abuse have increased as a result of household tensions due to enforced coexistence (multiple national lockdowns and working from home practices), economic stress related to loss of income, the disruption of social and protective networks and the decreased access to support services. This study aimed to understand how female survivors of parental intimate partner violence and abuse have experienced the adapted multi-agency response to intimate partner violence and abuse during the pandemic and consider learning from remote and hybrid working to influence future support. Method: This study adopted a qualitative research design, utilizing semi-structured interviews and a focus group. Data collection took place between March and September 2021. In total, 17 female survivors of intimate partner violence and abuse took part in the project; we conducted the semi-structured interviews via telephone (n = 9) and conducted an online focus group (n = 8). Results: Findings identified that services for those experiencing intimate partner violence and abuse need to be innovative, flexible and adaptable and ‘reach out’ to survivors rather than waiting for survivors to ‘reach in’ and ask for support. Findings show that the digital space highlights ‘missed opportunities’ for engagement with both professionals and peers and the potential for digital poverty is a key implication, which risks entrenching existing inequalities. Conclusion: In-depth consideration needs to be given to the design, delivery and evaluation of online interventions and provision of support to improve access and acceptability of services, maximize their effectiveness and to support the safety of survivors.

Within child welfare systems, the issue of parental alcohol misuse (PAM) and the responsibility for supporting children affected by PAM impacts on multiple health and social care services. An innovation pilot project (IPP) was set up to reduce the fragmentation between services and to help identify children affected by PAM. The current study presents findings regarding the IPP, examining its implementation, the service delivery, and the perceived impact for family members. Qualitative data were collected from 41 participants. This included interviews with alcohol-misusing parents (n = 13), affected adult family members (n = 5), and children affected by PAM (n = 9). Two focus groups and three one-to-one interviews were conducted with project workers (n = 7) and multi-agency service managers (n = 7). Data were analysed thematically relating to three main themes: (1) innovation in team composition and multi-disciplinary team working, (2) innovative ways of working, and (3) the benefits of a whole-family approach. The findings highlighted the importance of time for the team to 'bed in' and come together under one structure, a focus and oversight on whole-family care, and the importance of offering early, targeted, and flexible interventions to prevent crisis points and manage the consequences of PAM. Consideration will need to be given to joint commissioning to strengthen family-focused support.

Young people in care have a four-fold increased risk of drug and alcohol use compared to their peers. The SOLID study aimed to deliver two behaviour change interventions to reduce risky substance use (illicit drugs and alcohol) and improve mental health in young people in care. The study was carried out in 6 local authorities in the North East of England. Young people in care aged 12–20 years, who self-reported substance use within the previous 12 months were randomised to Motivational Enhancement Therapy, Social Behaviour and Network Therapy or control. In-depth 1:1 interviews and focus groups were used with young people in care, foster carers, residential workers, social workers and drug and alcohol practitioners to explore the key lessons from implementing the interventions. The Consolidated Framework of Implementation Research framed the analysis. Findings illustrated that the everyday interaction between individuals, service level dynamics and external policy related factors influenced the implementation of these new interventions at scale. We concluded that unless interventions are delivered in a way that can accommodate the often-complex lives of young people in care and align with the drug and alcohol practitioners’ and social workers priorities, it is unlikely to be successfully implemented and become part of routine practice.

Purpose Young people who are looked after by the state face challenges as they make the transition from care to adulthood, with variation in support available. In the past decade, funding has been directed towards organisations to pilot innovations to support transition, with accompanying evaluations often conducted with a single disciplinary focus, in a context of short timescales and small budgets. Recognising the value and weight of the challenge involved in evaluation of innovations that aim to support the transitions of young people leaving care, this paper aims to provide a review of evaluation approaches and suggestions regarding how these might be developed. Design/methodology/approach As part of a wider research programme to improve understanding of the innovation process for young people leaving care, the authors conducted a scoping review of grey literature (publications which are not peer reviewed) focusing on evaluation of innovations in the UK over the past 10 years. The authors critiqued the evaluation approaches in each of the 22 reports they identified with an inter-disciplinary perspective, representing social care, public health and organisation science. Findings The authors identified challenges and opportunities for the development of evaluation approaches in three areas. Firstly, informed by social care, the authors suggest increased priority should be granted to participatory approaches to evaluation, within which involvement of young people leaving care should be central. Secondly, drawing on public health, there is potential for developing a common outcomes’ framework, including methods of data collection, analysis and reporting, which aid comparative analysis. Thirdly, application of theoretical frameworks from organisation science regarding the process of innovation can drive transferable lessons from local innovations to aid its spread. Originality/value By adopting the unique perspective of their multiple positions, the authors’ goal is to contribute to the development of evaluation approaches. Further, the authors hope to help identify innovations that work, enhance their spread, leverage resources and influence policy to support care leavers in their transitions to adulthood.